Metacarpal fractures are common injuries – accounting for nearly 40 percent of all hand fractures. The fracture may occur at the base, shaft, head or neck of the metacarpal as a result of a direct blow, a fall onto the hand, or from the force of punching with a closed fist.

While the outer fingers and thumb are the most commonly affected, fractures at the neck of the little finger metacarpal – also known as boxer’s fractures – are among the most common types of injuries to the hand.

Metacarpal fractures are most often seen in boys and young men. In both the very young as well as the older age groups, metacarpal fractures generally result from a trauma such as a fall.

These types of fractures are classified according to the location of the break. The neck and shaft are the most common fracture sites for the second through fifth metacarpals. Most thumb metacarpal fractures occur at the base – though are treated differently, because of the biomechanics of the thumb.

While treatment depends on the severity of the fracture, most metacarpal fractures are minimally displaced (slightly out of alignment) and without rotational deformity, so closed reduction (pulling of bones back into place without an open incision) and short period of casting or splinting is all that is indicated.

Unstable or inadequately reduced fractures may require surgery and internal fixation, in order to ensure rigid immobilization and allow for early motion.